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Utility Service Application

  1. Storm Lake Jump Right In
  2. Utility Service Application
  3. First ~ Middle ~ Last

  4. Please check below to receive important alerts concerning The City Of Storm Lake. By checking the box you agree to receive email and/or text alerts form CivicPlus. We will never sell your information a third party and you may opt out at any time. *
  5. Please check below to receive important alerts concerning The City Of Storm Lake. By checking the box you agree to receive email and/or text alerts form CivicPlus. We will never sell your information a third party and you may opt out at any time. *
  6. Please list all other adult occupants living in the home: 

  7. Billing Information
  8. City ~ Street ~ State ~ Zip Code

  9. By submitting this application for Utility Service with The City of Storm Lake I understand that I am responsible for all utility usage at this property and The City of Storm Lake will disconnect service for unpaid balances on my account. I also understand that bills are due on or before the 15th of each month. If I am renting, I will be subject to a rental deposit as currently set by the City Council. I hereby confirm that the information provided in this application is accurate and true and that I will notify The City of Storm Lake within three business days if any of the information provided on this application changes. I also hold The City of Storm Lake harmless from any damages caused by my failure to notify The City of Storm Lake of changes to contact information contained on this application. I also understand that only those persons listed on this application and designated as such are authorized to make changes to my account including having water turned off and closing the account. I agree to abide by and comply with the regulations of The City of Storm Lake for Utility Service for the duration of my service period. *
  10. Capture
  11. Please Keep this application for your records.

    You are responsible for notifying The City of changes to this application and for all changes on this account from the date of service on this application.

  12. City of Storm Lake ~ Utility Billing Department ~ 620 Erie Street ~ Storm Lake, I A 50588 ~ 712-732-8020
  13. Leave This Blank:

  14. This field is not part of the form submission.